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Advancing)Technology:))Point)of)care)documenta7on)op7ons.

David Tapia, MBA, FACHE

Presentation Objectives

•  The&learner&will&be&able&to&iden6fy&at&least&two&benefits&and&two&barriers&to&point&of&care&documenta6on&in&their&prac6ce.

•  The&learner&will&be&able&iden6fy&at&least&two&different&point&of&care&devices&that&may&be&appropriate&in&their&prac6ce.&&

•  The&learner&will&be&able&to&demonstrate&how&to&u6lize&a&decision&making&path&focused&on&key&considera6ons&for&choosing&a&point&of&care&device&for&their&prac6ce.

POC Documentation Benefits of Using Technology in the Home

"  Real-time information "  Documentation "   Interdisciplinary communication "  Coordination of care "  Efficiency "  Reduce mileage "  Employee satisfaction

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POC Documentation Barriers of Using Technology in the Home

"  Patient interaction "  Clinician resistance "  Cost/affordability "  Learning curve/training/support "  Loss/damage "  Extra piece of equipment to carry "   Incorrect notion that it hinders productivity

Optimal Decision Making Path

Step 1: Analyze Your Current Situation

"  What types of devices are you using for POC documentation?

"  What type of system (MR/EMR) are you currently using for documentation? Are you still on paper?

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Step 2: Identify the Opportunity or Problem

Step 3: Establish Your Goals

Example: To select a device that will help you to remove these barriers and experience the benefits of improved POC documentation.

Step 4: Research / Identify Your Options

"   Internet research "  Web demonstrations "  Networking "  Employee feedback "  Test devices "  Get references – site visit

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POC Devices Optional Financing Models

"  Employer sponsored "  Employee owned "  Hybrid "  Mobile Device Management model

"   Option to Lease tablets vs buy

"   Remote lock & wipe tablets in case lost or stolen

"   Control data usage per user to avoid expensive overages

"   Use geo-fencing and GPS for security measures

What’s Out There?

Step 5: Evaluate Your Options

"  Notebook/Laptop "  Netbook "  Tablet PC "  New tablets "  Other (e.g., handheld/smartphones)

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What to Look for in a POC Device POC Software Compatibility

Client-server Solution:

"  Notebook/Laptop "  Tablet PC

Web-based Solution:

"  Notebook/Laptop "  Tablet PC "  Netbook "  New tablets

What to Look for in a POC Device Prioritize this List

"  Compatibility (Software & Flash)

"  Affordability "  Portability "  Ease & speed of

use "  Display (size) "  Multi-functionality

"  Connectivity** "  Battery life "  Camera "  Performance "  Storage "  Apps/other software "  Accessories**

Comparing POC Devices Best in Each Class

Laptop Netbook Tablet PC Tablets Initial Investment X Monthly Access X Portability X Web-based EMR X X Web-based & Client-Server X X Flash Compatibility X X X X Intuitive (Less Training Req.) X Speed of Use X Ease of Documentation X X X Reduced patient barrier X X Battery Life X Camera X Storage X X Maintenance X

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POC Devices New Tablets

"  Apple iPad 4 "  Asus Vivo Tab "  Dell XPS "  Microsoft Surface "  Other Tablets:

•  Sony Xperia Tab Z •  Google Nexus 7 •  Samsung Note 8

New Tablets Key Benefits

"  Easy to carry "  Easy to use "  Cost effective "  More efficient "  Reduces common barrier "  Useful applications "  Other usage opportunities

Tablets Key Differences

"  Screen size (7-10 in) "  3G/4G connectivity "  Wireless carriers "  Compatibility (EMR

& Flash) "  Operating systems

"  Storage options "  Cameras "  Apps/other software "  Accessories

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iPad 4 & iPad mini

Advantages)•  Both&are&lightweight&and&portable&•  Powerful&processors&•  Great&reputa6on&and&brand&recogni6on&•  Intui6ve&Opera6ng&System&•  Op6on&between&7.8”&or&9.5”&screen&

Disadvantages)•  No&external&storage&or&

memory&expansion&•  Opera6ng&system&is&very&

restricted&•  No&Flash&compa6bility&&

Pricing)•  iPad&mini’s&start&at&$329&•  iPad&4&starts&at&$499&

Asus Vivo Tab

Advantages)•  Large&screen&12”&with&docking&keyboard&•  Powered&by&new&Windows&8&OS&•  Digital&stylus&easily&integrates&wri6ng&func6on&•  External&expansion&and&media&slots&

Disadvantages)•  New&Windows&8&OS&–&some&learning&

curve&•  Might&be&too&large&for&some&

clinicians&•  Price&

Pricing)•  Star6ng&at&$799&

Dell XPS New class of devices called “Convertibles”

Advantages)•  Large&screen&12.5”&&•  Powered&by&new&Windows&8&OS&•  Serves&as&both&a&tablet&and&laptop&•  External&expansion&and&media&slots&

Disadvantages)•  New&Windows&8&OS&–&some&learning&

curve&•  Isn’t&this&just&a&big&superfast&laptop?&•  High&price&

Pricing)•  Star6ng&at&$1199&

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Microsoft Surface RT & Pro

Advantages)•  Both&are&lightweight&and&portable&•  Large&10”&screen&•  Created&specifically&to&compete&with&iPads&•  Docking&Keyboard&op6ons&•  External&slots&for&media&&&storage&expansion&

Disadvantages)•  New&Windows&8&OS&–&some&learning&curve&•  Keyboard&on&Surface&RT&feels&cheaply&made&•  Surface&Pro&is&more&clunky&and&larger&•  High&price&for&the&Pro&

Microsod&Surface&RT&

Microsod&Surface&Pro&

Pricing)•  Surface&RT&starts&at&$499&•  Surface&Pro&starts&at&$999&

Google Nexus 7

Advantages)•  Latest&version&of&Android&4.1&JellyBean&•  Great&bafery&life,&fast&processor&•  Above&average&screen&resolu6on&•  External&slots&for&media&&&storage&expansion&•  Rated&the&“Best&$200&Tablet&you&can&buy”&–&by&

Engadget&

Disadvantages)•  Screen&size&7”&might&be&too&small&for&POC&•  Only&has&a&front&camera&•  Few&expansion&slots&•  No&3G/4G&op6ons&

Pricing)•  Starts&at&$199&

Samsung Galaxy Note 8

Advantages)•  Latest&version&of&Android&4.1&JellyBean&•  Powerful&processor&•  New&Stylus&features&electromagne6c&proper6es&•  External&slots&for&media&&&storage&expansion&•  “Watch&On”&feature&serves&as&a&universal&

remote&and&media&hub&

Disadvantages)•  OS&loaded&with&features&might&not&be&easy&to&

navigate&for&a&new&user&•  Price&

Pricing)•  Starts&at&$399&

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Sony Xperia Tab Z

Advantages)•  Latest&version&of&Android&4.1&JellyBean&•  Large&10”&screen&near&Re6na&display&•  External&slots&for&media&&&storage&expansion&•  Water&resistant&and&dustiproof!&

Disadvantages)•  Sony&is&s6ll&new&to&the&tablet&market&•  Brand&new&models&typically&need&at&least&

one&genera6on&to&work&out&kinks&•  Price&

Pricing)•  Will&be&released&in&Q2&2013&•  Overseas&pricing&around&

$899&

Optimal Care Tips

"  Flexibility is key "  Remain open to

better opportunities "  Utilize the benefits of

technology advancement

"  Tech excellence contributes to clinical excellence!

"  Have a backup plan "  Anticipate anxiety "  Mutually set a realistic

learning curve "   Invest in device

accessories "  Try new ways of using

your device

Thank You For Attending. We have devices available for demonstration

Questions? Ask now or contact us via email.

Dave&Tapia,&MBA,&FACHE&Managing&Partner&Exegete&Healthcare&Interna6onal,&LLC&davetapia@exegetehealthcare.com&&

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Addendum Case Study Optimal Care’s Mission

To provide the highest quality care with compassion and respect for each person

through personal, clinical and technological excellence.

Optimal Care Case Study&Timeline

Census started at 20 patients and grew rapidly to a census of 200 in first year

"  2006: Paper documentation – standard-based forms

"  2008: Transitioned to client-server system using Tablet PCs

"  2010: Transitioned to Web-based system using iPads and multiple devices

Optimal Care in 2008 Client-server Software + Tablet PCs

Initial Investment $300,000 Monthly Costs $5,000

License Fees User $3,500/User Host $4,000/Host HHA $3,000/HHA License

Laptops/Tablet PCs $2,000/Each

PDAs – HHA Documentation $50/Mo Activation

Security Software Licenses $120/Tracking

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Client Server Software Solution Weaknesses

Administrative: "  Cost for growth "  Device "  License "  Dependence on IT "  Training – 40+

Hours "  Theft – HIPAA

concerns

Clinical: "  Device limitations "  Delayed

documentation "  Lengthy sign-on time

•  Tablet PC •  Software program

"  Employee dissatisfaction

Tablet PC Weaknesses

"  Larger, more difficult to carry "  Battery life "   Internet access "  Updates "  Requirements

Web-based Software Solution Opportunities

Administrative: "  No upfront costs or

for growth "  Billing/financial

integration "  Real-time QA "  Reporting capability "  Replace IT "  No HIPAA concerns

Clinical: "  More oversight "  Coordination of Care "   Improved

communication "  Survey-ready "   Improved

documentation "  Process improvement

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Optimal Care in 2010 Goals for New Software + Devices

"  To find a mission-driven solution for both administrative and clinical care needs

"  Employee satisfaction "  Administrative oversight "  Real-time documentation

Optimal Care Case Study Web-based Software + iPads

Initial Investment $35,000 Monthly Costs

$5,500 (Maintenance + Web) License Fees $0 Tablets $600/Each Web Connection Fees $15-25/Month

Apple iPad Opportunities

Administrative: "  Affordable pricing &

plans "  Dependable "  Less training

needed "  Works with EMR

Clinical: "  Easy to use & carry "  GPS "  Performance "  Patient education

tool "  Compatible

keyboard cases

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Optimal Care Results

"   iPads provided to all clinicians "  True Point of Care "  >90% of actual POC documentation "   Improves work/life balance

“The iPad is Wonderful! I no longer go home and spend the evening with a laptop on my lap. My work is already done.”

Optimal Care Results

"  Quality assurance oversight "  Survey/record audit-ready "  Real-time interdisciplinary communication "  Using the latest technology to deliver the

highest quality care

“With the iPad, I can now play my patient her favorite music as part of her dementia care!”